Social Cognitive Impairments and Negative Symptoms in Schizophrenia: Are There Subtypes With Distinct Functional Correlates?
Social Cognitive Impairments and Negative Symptoms in Schizophrenia: Are There Subtypes With Distinct Functional Correlates?
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DOI：
10.1093/schbul/sbr125
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发表时间：
2013-01-01
影响因子：
6.6
通讯作者：
Wexler, Bruce E.
中科院分区：
文献类型：
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作者：
Bell, Morris D.;Corbera, Silvia;Wexler, Bruce E.
社会认知障碍和阴性症状是精神分裂症的核心特征，与社区功能受损密切相关。然而，很少有人知道这些是否是疾病的独立维度，如果是的话，精神分裂症患者是否可以根据这些维度（SANS）进行有意义的分类，并可能进行差异化治疗。在77例门诊患者的样本中，5项社会认知测量加上阴性症状评估量表（SANS）和阳性和阴性症状量表（PANSS）评分产生了2个不同的因素-社会认知因素和阴性症状因素。因子评分用于聚类分析，产生3个定义明确的组-高阴性症状组（HN）和2个低阴性症状组，1个具有较高的社会认知（HSC）和1个具有较低的社会认知（LSC）。为了使这些发现在研究和临床环境中更实用，创建了仅使用Mayer-Salovey-Caruso情商测试和PANSS阴性成分进行分类的经验法则，并与原始聚类组产生了84.4%的一致性。另外增加了63名受试者，以交叉验证经验法则。当样本合并时（N = 140），HSC组的生活质量和整体功能评估（GAF）评分显着更好，结婚率更高，住院率更高。LSC组有更严重的犯罪和药物滥用历史。使用2种常见的评估工具，精神分裂症患者可以分为3个亚组，这些亚组对社区融合有不同的障碍，并且可能从不同的治疗中受益。
Social cognitive impairments and negative symptoms are core features of schizophrenia closely associated with impaired community functioning. However, little is known about whether these are independent dimensions of illness and if so, whether individuals with schizophrenia can be meaningfully classified based on these dimensions (SANS) and potentially differentially treated. Five social cognitive measures plus Scale for the Assessment of Negative Symptoms (SANS) and Positive and Negative Syndrome Scale (PANSS) scores in a sample of 77 outpatients produced 2 distinct factors-a social cognitive factor and a negative symptom factor. Factor scores were used in a cluster analysis, which yielded 3 well-defined groupings-a high negative symptom group (HN) and 2 low negative symptom groups, 1 with higher social cognition (HSC) and 1 with low social cognition (LSC). To make these findings more practicable for research and clinical settings, a rule of thumb for categorizing using only the Mayer-Salovey-Caruso Emotional Intelligence Test and PANSS negative component was created and produced 84.4% agreement with the original cluster groups. An additional 63 subjects were added to cross validate the rule of thumb. When samples were combined (N = 140), the HSC group had significantly better quality of life and Global Assessment of Functioning (GAF) scores, higher rates of marriage and more hospitalizations. The LSC group had worse criminal and substance abuse histories. With 2 common assessment instruments, people with schizophrenia can be classified into 3 subgroups that have different barriers to community integration and could potentially benefit from different treatments.